Benefit Forms

Please select the form you require from the bottom of this page, download it, print it and return it by post to the appropriate address.

The online forms are PDF files and require Adobe Acrobat Reader to be able to view them. You can download this software free from www.adobe.com.

All the forms are available in the local Housing Offices. Benefit forms can be made available in community languages upon request.

Housing and Council Tax Benefit claim forms

If you are on a low income, you may be entitled to Housing and/or Council Tax Benefit. You can claim Housing Benefit if you are liable to pay rent to the Council, a registered social landlord (Housing Association) or a private landlord. You can claim Council Tax Benefit if you are aged 18 or over and are liable to pay Council Tax on the home you live in.

Property / Tenancy Details Form

You need to complete one of these forms if you pay rent for your property to someone other than the Council eg private landlord, Housing Association

Statement of rent

If you are a tenant of a private landlord and do not have a tenancy agreement, you should ask your landlord to complete one of these forms for you to support your benefit application.

Pre-tenancy determination form

You complete this form if you are thinking of renting accommodation from a private landlord (not the Council or a Housing Association) and you are likely to need Housing Benefit to pay your rent. You can now find out if the rent will be restricted before you decide to rent the property. You should be aware that this would not necessarily be the amount you will receive. It will also depend on your personal circumstances.
A pre-tenancy determination is a rental valuation by the independent Rent Service. This valuation gives you the rent figure, which will be used by the Housing Benefit Service to work out your Housing Benefit.

Appointee/Authorisation form

This form needs to be completed if you would like someone else to deal with your benefit claim on your behalf or you can agree for the Council to disclose your benefit information to another person. N.B. the Council will only make someone an appointee if it considers that they are suitable to deal with your affairs.

Statement of Employer Form

You will need to have this form completed by your employer if you do not have your last five weekly payslips or your last two monthly payslips or if your payslips are hand written.
If you are self-employed and wish to claim Housing/Council Tax Benefit, you will need to complete this form as well as your benefit application form.

Changes in circumstances form

You need to complete this form if any of your circumstances have changed since the date that you last claimed Housing or Council Tax Benefit. Please report all changes even if you do not think that they will affect your benefit. Some examples of changes are shown below but there may also be other changes that you should tell us about.

• a change in your household
• a change to your income
• you are moving out
• your rent has changed
• your landlord has changed

Change in State Benefits Form

You need to complete this form if your Income Support or income-based Job Seekers Allowance stops and you wish to continue your claim.

Benefit appeal form

You need to complete this form if you wish to appeal against a decision made on your benefit entitlement. You must submit this form within one calendar month of receiving your decision.